Michigan HIV/AIDS Drug Assistance Program (MIDAP) Qualifications

What Is Covered?

MIDAP currently covers HIV-specific and related medicines, as well as vaccines. The MIDAP-eligible drug list and the MIDAP Pharmacy Network List
(pharmacies that can fill your prescriptions) can be found at ScriptGuideRX.com/midap.

Who Qualifies?

To be eligible for MIDAP:

Applicant must provide documentation of HIV disease.

Applicant must provide proof of residency in the state of Michigan.

In some cases, applicant must have applied for public assistance (Medicaid and/or Adult Benefits Waiver program) with the Department of Human
Services (DHS) within the past 90 days and have a pending, denial, or spend-down status.

Applicant's gross income cannot exceed 450 percent of the Federal Poverty Level (FPL) and will be evaluated based on FPL guidelines in effect when MIDAP receives your completed application.

How Do I Obtain Services?

Case management and client advocacy agencies, or the MIDAP staff, can assist applicants in completing the MIDAP application. Completed applications
will be reviewed and accepted or denied. If approved by the MIDAP, the client will receive a prescription card with a personal identification
number.

Forms and Instructions

Please Note: The following forms and documents are available as Adobe Acrobat PDF files. You will need a Adobe Acrobat or Adobe Acrobat
Reader to use them. Adobe Acrobat is a free program available through Adobe. Download it
now.